Urinary tract infections in men

Last reviewed: 3 Nov 2022
Last updated: 17 Nov 2022

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • dysuria
  • urgency
  • frequency
  • suprapubic pain
  • costovertebral angle pain
More key diagnostic factors

Other diagnostic factors

  • hesitancy
  • nocturia
  • enlarged prostate
  • tender prostate
  • rectal/perineal pain
  • fever/rigors
  • urethral discharge
Other diagnostic factors

Risk factors

  • benign prostatic hypertrophy
  • urinary tract stones
  • urological surgery, instrumentation
  • urethral strictures
  • age >50
  • previous UTI
  • catheterisation
  • anal sex
  • vaginal sex
  • recent hospitalisation
  • uncircumcised
More risk factors

Diagnostic investigations

1st investigations to order

  • dipstick urinalysis
  • urine microscopy
  • urine culture
  • Gram stain
More 1st investigations to order

Investigations to consider

  • CT renal tract
  • ultrasound
  • plain x-ray kidneys, ureters, and bladder (KUB)
  • intravenous urogram (IVU)
More investigations to consider

Treatment algorithm

INITIAL

asymptomatic bacteriuria before urological procedure

ACUTE

not severe and tolerating oral therapy

severe or not tolerating oral therapy

Contributors

Authors

Timothy J. Benton, MD
Timothy J. Benton

Regional Chairman

Residency Program Director

Associate Professor

Department of Family and Community Medicine

Texas Tech University Health Sciences Center

Permian Basin Campus

Odessa

TX

Disclosures

TJB declares that he has no competing interests.

Peer reviewers

Catherine DuBeau, MD

Professor of Medicine

Dartmouth Hitchcock Medical Center

Lebanon

NH

Disclosures

CD is a member of the American Geriatrics Society Revision Panel for the Beers criteria for potentially inappropriate medications in older persons; planning committee, speaker, and manuscript co-author for the American Urogynecological Association State of the Science on OAB and cognition; and co-investigator, RELIEF trial (botulinum toxin for refractory overactive bladder in older women, funded by PCORI.

Richard Viken, MD

Professor of Family Medicine and Chairman of the Department of Family Medicine

University of Texas Health Sciences Center

Tyler

TX

Disclosures

RV declares that he has no competing interests.

Robert Pickard, MD, FRCS (Urol)

Professor of Urology

Institute of Cellular Medicine

Newcastle University

Newcastle upon Tyne

UK

Disclosures

RP declares that he has no competing interests.

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